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This post is the first in a series I am dedicating to discussing the topic of ADHD. In my practice, I frequently encounter individuals with ADHD. I’d like to share my thoughts on what I’ve witnessed as a pharmacist, helping patients and their families navigate this condition, and what I believe the future of ADHD may look like.

What is ADHD and how do we treat it?

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that manifests in childhood and is characterized by hyperactivity, impulsivity and/or inattention. It is one of the most common neurodevelopmental disorders in Canada, affecting 4-6% of adults and 5-7% of children. Some children begin expressing symptoms as early as pre-school, and the condition may continue into adulthood.

Diagnosing ADHD can be tricky since it requires subjective assessment and interpretation of another’s behaviour. What may seem like problematic behaviour to one parent or practitioner may seem normal to another. Once a diagnosis has been identified, the typical treatment options include pharmacotherapy with stimulant or non-stimulant medications, preferably in combination with cognitive behavioural therapy (CBT). Establishing goals of therapy is essential and should focus on improving executive function and self-regulation, instead of improving performance and test results.

Self-Regulation and Executive Function

ADHD is often characterized as a disorder of self-regulation and executive function. Individuals with ADHD can have difficulty managing their behaviour and reaction to their environments (self-regulation), leading to challenges in processing information, planning and focusing attention and completing tasks (executive function).

I’m a big proponent of Dr. Gabor Mate and his take on ADHD and its roots in childhood development. I believe that self-regulation can be developed and instilled in children at a very young age. How to do this is the very question I ask myself on a daily basis, and I will cover that topic in a subsequent post.

I’m quite fortunate to work in pediatrics and have exposure to family units, sharing in the challenge of navigating healthcare post-pandemic. In the pediatric urgent care clinic, I get to observe a broad spectrum of parental techniques and child management strategies, particularly in distressful situations – I understand it’s never easy handling a child when they’re unwell. Being in this unique position, I’ve noticed certain patterns immerge.

Smartphones and Ten-Second Attention Spans

One thing of concern I notice often is the use of smartphones in the hands of infants, toddlers and young children. Context is important and the environment matters. Sometimes when your child is crying, you’ll do anything to soothe their discomfort. However, I can’t help but notice disturbing trends in relying too often on the quick fix. Sure there may be no direct harm in watching a 3-minute Cocomelon video or playing Angry Birds, again, context is important and the environment matters.

I frequently think about the behavioural impact early use of phones and technology may have on the developing brain. If kids get introduced to using smartphones in their infancy or toddlerhood, how will this impact their attention and ability to focus?

Currently, TikTok is the number one app in the world, and ten-second video clips seem to be the trend de jour. Tech companies and app developers are getting better and better at capturing our attention and holding onto it, utilizing the power of dopamine to their advantage. When I see a toddler infinitely scrolling, or a young child glued to the screen, I imagine a future in which children will be dependent and habituated to devices to provide not just entertainment, but constant stimulation and pacification. It’s possible that we’ll continue to see rates of childhood and adult ADHD rise in the coming decades, only time will tell how this social experiment will play out.

Part II

In part two, I’ll dive a little deeper into the War on Attention, and how social media and big tech have impacted mental health trends in the last decade.

Infinite gratitude and peace. SG.